We carried out an unannounced inspection of the service on 12 May 2017. Lawrence Mews is registered to provide accommodation for up to five people who require accommodation or personal care, all of whom had a learning disability. At the time of the inspection there were five people living at the home.

On the day of our inspection there was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The risk to people’s safety was reduced because staff understood the procedure for reporting concerns, had attended safeguarding adults training and could identify the different types of abuse. Risk assessments had been completed in areas where people’s safety could be at risk, including the environment and risks to their day to day health. Accidents and incidents were investigated. People had the freedom to live their lives as they wanted to. Staff were recruited in a safe way and there were enough staff to meet people’s needs and to keep them safe. People’s medicines were managed safely.

People were supported by staff who felt well trained and supported by the registered manager to carry out their role effectively. People and their relatives felt staff understood how to support them effectively.

The registered manager ensured the principles of the Mental Capacity Act (2005) had been applied when decisions had been made for people. The registered manager was aware of the requirements to apply for and implement Deprivation of Liberty Safeguards.

People were encouraged to lead a healthy and balanced lifestyle and support was in place for new people to the home to help determine their food likes and dislikes. People’s day to day health needs were met by the staff and external professionals. Referrals to relevant health services were made where needed.

People had excellent, meaningful relationships with the staff. People were treated with respect and dignity and staff were very kind and caring towards them. Staff understood the importance of providing dignified care and support and did so to a high standard. People were encouraged to lead independent lives and care and support was tailored to enable people to do so. Innovative methods were used to communicate with people and there were individualised processes in place to help people understand and contribute to, decisions about the care. All people were treated equally with staff having an excellent awareness of how to respect people’s rights. People were provided with the information they needed if they wished to speak with an independent advocate, to support them with decisions about their care. People’s friends and relatives were able to visit whenever they wanted to and people were supported to develop and maintain relationships with family and friends.

People received excellent person centred support focused on what mattered most to them. Clear processes were in place to ensure that people had a smooth transition when moving into the home. People’s care and support needs were frequently discussed with them and progress on achieving their goals was regularly reviewed. People were encouraged to take part in activities that were important to them and staff provided as much or as little support as people wanted. People were provided with the information they needed, in a format they could understand, if they wished to make a complaint.

People, relatives, staff and health and social care professionals spoke highly of the registered manager; they found her to be dedicated, approachable and supportive. The provider, via their Head of Care demands excellence and registered managers were provided with the resources needed to aim high and to achieve the best possible resul

We inspected the service on 16 December 2014. Lawrence Mews is designed to accommodate up to 5 people in two separate units. They are registered to provide accommodation for persons who require nursing or personal care. On the day of our inspection 3 people were using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

The environment was warm, clean and homely and the security measures protected people from intruders. People were safe and protected from avoidable harm by effective management which identified hazards and implemented suitable risk reduction actions. Staff were continually vigilant with care practices and had ways of reporting any concerns to keep people safe.

People were supported by a caring staff team who knew them well, respected their decisions and protected their rights.

Staff worked alongside people, providing help and advice on healthy eating and promoting their health and wellbeing to enhance their quality of life.

People were treated as individuals, they had their care reviewed regularly to make sure it was still effective or if things needed to change. External health and social care professionals worked with the staff to make sure people received safe support when their behaviour put them or others at risk.

People had regular and unrestricted access to their family and their friends. They had opportunities to have the social and leisure activities they needed to lead a fulfilling life.

There was good leadership, management and mentoring. There was a positive culture where staff behaviour was constantly reviewed. The culture of the service recognised and valued the essential contribution of families and friends to the wellbeing of the person they cared about. The manager worked in partnership with the NHS and local authority in supporting people who used the service.

We used a number of different methods to help us understand the experiences of people using the service, because they had complex needs which meant they were not able to tell us about all of their experiences.

We were supported by a staff member to speak with one person using the service. We also observed staff interacting with people. We spoke with two relatives, three members of staff and the manager. We also looked at care records and other information.

A member of staff facilitated us talking with a person using the service. When we asked the person using the service if they liked the home and if they were happy living there, they said, “Yes.”

Both relatives told us they were really happy with the service on offer and the staff were nice and pleasant. They told us they felt involved in their relative’s care and they were always kept informed. One relative said, “The manager tells the truth and I am glad of that, I am very happy with everything.” The other relative said, “[My relative] is getting what they need, I am really pleased, I think [they] are safe and are being looked after.”

We found that the people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We found staff supported people using the service to have a nutritious intake. People were also supported to be involved in food planning, shopping and preparation.

We found there had been improvements made to the building and the home was well maintained. Both relatives told us they were happy with the environment and they felt it was well maintained. One relative said, “They replace furniture when it is damaged.” The other relative said, “It’s a lovely place, [my relative] has lovely home.”

There were sufficient staff available to support people and we saw that staff were attentive to people’s needs.

We saw there had been an improvement in regards to record keeping and records were stored in a confidential manner.

There was one person living at Lawrence Mews when we visited. Their learning disability had affected their communication and we therefore spent a period of time with them in their home observing their experiences and their interactions with the staff. We also spoke with care staff and management staff and looked at records.

At the time of our visit five people were living at John Charles House. Due to people's complex needs we were only able to speak with two people and one of these needed help from a care worker to respond to our questions.

One person told us they were happy living at the care home, that staff helped them when needed, and that they felt their needs were met at John Charles House. The other person we spoke with showed, by their expression, that they were also were happy at John Charles House. The support worker confirmed this.

One person who uses the service told us that they liked the food at John Charles House and added they got as much as they wanted.

One person who uses the service told us that they felt safe living at John Charles House and that nothing was worrying them. The other person's support worker showed awareness of the person's needs by telling us about what unsettles them.

One person felt that John Charles House was kept in a nice state and that it was kept clean and tidy. They told us that they could have a shower when they wanted and that staff encouraged them to shower. They thought that staff were good at their job and kind and helpful to them. They added that staff showed an interest in them. They also told us that they got their medicine as needed.